CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Good Shepherd Specialty Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $2,775
Cash Discount Price: $2,500
vs. Medicare Baseline: 0.20x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Good Shepherd Specialty Hospital is $2,775. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,500. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.20x the Medicare baseline. Located in 2545 Schoenersville Road, Bethlehem, PA.

Cash / Self-Pay

$2,500

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,775

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$14,116.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,116.91 (100%)

Cash / Self-Pay: $2,500 (18%)

Insurance Median: $2,775 (20%)

Cash: $2,500 (18% of Medicare)

Ins. Median: $2,775 (20% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,116.91 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UPMC	$1,565 - $2,812	11%
Geisinger	$1,632 - $2,100	12%
Aetna	$1,949 - $2,581	14%
Blue Cross Blue Shield	$2,094 - $3,079	15%
Cigna	$2,154 - $50,428	15%
Devon Health	$2,204 - $2,579	16%
Everyday Life	$2,649 - $3,175	19%
UnitedHealthcare	$2,766 - $3,418	20%
Amerihealth	$2,775 - $3,079	20%
Lehigh Valley Health Network	$35,300	250%
Multiplan	$35,300	250%
Prime Health	$35,300	250%
Humana	$47,402 - $50,932	336%
Choice Care	$50,428	357%
Clover Health	$50,428	357%
Highmark	$50,428 - $65,047	357%
Highmark Wholecare	$50,428	357%
Medicare (plans)	$50,428	357%
PA Health and Wellness	$50,428 - $51,437	357%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,500.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Good Shepherd Specialty Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.